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Tarsal Tunnel Syndrome & Nerve Entrapments

= Compression of the tibial nerve in the tarsal tunnel

Anatomy:The Tarsal Tunnel - From Stoller: MRI Arthroscopy & Anatomy of the Joints

The tarsal tunnel is formed by the flexor retinaculum behind and distal to the medial malleolus

Contents from ant. to post.: (Tom Dick ANd Harry)

  • Tibialis Posterior Tendon
  • Flexor Digitorum Longus tendon
  • Posterior Tibial artery
  • Posterior Tibial Nerve
  • Flexor Hallucis Longus tendon

Posterior tibial nerve 

  • is a branch of the sciatic nerve 
  • enters the deep posterior compartment of the leg between the two heads of the gastrocnemius. 
  • It passes deep to the soleus and travels distally between it and the posterior tibialis muscle. 
  • 3 terminal branches in the tarsal tunnel
    • medial plantar nerve - Sensation to the plantar-medial aspect of the foot from the great toe to the medial half of the 4th toe. Motor to the abductor hallucis, flexor brevi &  the 1st lumbrical.
    • lateral plantar nerve - Sensation to the 4th & 5th rays & toes. Motor to ADQ, the interossei, adductor hallucis, 2nd to 5th lumbricals. 
    • the calcaneal branch - can be of a variable origin. Provides sensation to the heel pad.


  1. An accessory FDL muscle 
  2. Proliferative synovitis - Rheumatoid
  3. Ganglia 
  4. Varicosities
  5. Lipomas
  6. Neurilemomas 

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